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Trial of BCG vaccines in south India for tuberculosis prevention: first report--Tuberculosis Prevention Trial.

The protective effect of BCG vaccination is being evaluated in a controlled community trial near Madras in south India. After tuberculin and sensitin testing and radiographic and bacteriological examinations, BCG vaccines and placebo were allocated randomly to about 260 000 individuals, of whom 115 000 were definitely tuberculin negative at the time of vaccination. Intensive efforts are being made, by means of regular follow-up surveys, to identify all new cases of tuberculosis occurring in the community. This report presents the findings of the first 7(1/2) years of follow-up. Incidence of infection was high in the study population. However, incidence of bacillary disease was more frequent among initial tuberculin reactors, especially among the older persons, than among non-reactors of whom the majority were in the younger age groups. The distribution of new cases of bacillary tuberculosis among those not infected at intake did not show any evidence of a protective effect of the BCG vaccines.

Adolescent

Distribution of A1A2BO and Rho (D) blood groups in tribal populations of Andhra Pradesh, South India.

The paper reports the distribution of A1A2BO and Rho (D) blood groups among five tribal populations, Koya Dora, Raj Gond, Naikpod, Pardhan and Lambadi from three districts of Andhra Pradesh, South India. Blood samples from a total of 1090 unrelated individuals were tested. Koya Doras were, however, sampled from five distant localities to find out intratribal variation, if any. In A1A2BO blood group system the combined frequencies of "P1" and "P2" among the five Koya Groups always exceeded the frequency of "q", a characteristic feature of many tribal populations of Andhra Pradesh. However, among Raj Gond, Naikpod, Pardhan and Lambadi tribes the frequency of "q" is higher than "p" with the maximum in Pardhans. The frequency of "r" is always higher than the combined frequencies of "p1" and "p2" except in Raj Gonds. The higher frequency of "q" over "p" among Naikpod, Pardhan and Lambadi tribes is indicative of a tendency towards the distribution pattern found in North India. A few Rh negative persons were detected only in Koya Dora, Raj Gond and Lambadis indicating that the allele r (cde) is present in these populations, although in a low frequency.

ABO Blood-Group System

HLA-linked genes and leprosy: a family study in Karigiri, South India.

The evidence for a genetic determination of susceptibility to leprosy is reviewed. To test the hypothesis that an HLA (histocompatibility leukocyte antigen)-linked gene is associated with such susceptibility, the association between the distribution of leprosy within a family and the segregation of HLA haplotypes was investigated among 72 families who lived in Karigiri, Tamil Nadu State, South India. A statistically significant association was found for families in which siblings had tuberculoid leprosy and in which neither parent had leprosy. The findings from the data of this study agree with those of two previous studies carried out among smaller populations is Surinam and Wardha, Maharashtra State, India. Such an agreement suggests that a genetic determinant which is linked to the major HLA locus on chromosome 6 and which is probably recessive affects susceptibility to tuberculoid leprosy in humans.

Alleles

Alcohol metabolism and sensitivity reactions among the Reddis of South India.

Alcohol was given orally to 41 healthy young male volunteers from small Hindu (Reddis) farming villages in south and central Andhra Pradesh, India. A complete description of the Reddis study, plus transcultural group differences, is given, and the alcohol metabolism and sensitivity literature is critically reviewed.

Adolescent

Colorectal carcinoids in South India.

Twenty cases of colorectal carcinoids are reviewed in this report. Among the South Indian Asiatic, the colorectal carcinoids are apparently more common than appendicular and small intestinal carcinoids. The data obtained in this survey and the experience in America, citing increased incidence of such carcinoids in Negroes, suggest that racial factors are responsible for certain differences. The tendency to involve younger age groups and many cases having aggressive potentialities are other variations encountered in this review. A brief summary of its characteristic histopathology is given.

Adult

Genetic load in an isolated tribal population of South India.

The Kota of Nilgiri Hills, Tamilnadu, are an isolated tribal population and occupy the lowest stratum in the local social hierarchy. They have developed an economic symbiotic relationship with other tribes of the Nilgiri Hills (e.g., Toda, Kurumba, Badaga), but have almost no social relationship with other communities, such as the Hindu and Muslim, communities, etc. The total population of the Kota is about 1200. Consanguineous marriages are highly favoured in this group. This paper presents data on prenatal, infant and adolescent mortality in relation to the degree of inbreeding. No perceptible difference has been found in mortality figures between consanguineous and non-consanguineous marriages. This may be due to the long history of inbreeding among the Kota. No case of visible congenital malformation has been noticed. The estimates of genetic load as revealed by inbreeding data indicate that genetic load in the Kota is low (perhaps about 1 lethal equivalent per gamete); it is also low in comparison with that in other Indian populations.

Abortion, Spontaneous

Efficiency of address cards, experienced health visitors and motivated registry clerks in obtaining the home address of urban patients in South India.

The address card, a card on which the patient's home address is asked to be recorded by the local postman, or by a knowledgeable and literate neighbour, relative or friend, was investigated for acceptability and efficiency in 4 tuberculosis out-patient clinics, in an urban community with substantial levels of illiteracy in Madras City. In the 4 clinics combined, 96% of the patients who reattended returned the completed card. Letters posted to the address on the cared were received by 85% of 419 patients, while 5% were returned by the post office as undelivered and a further 4% were, in all probability, not delivered; no information was available about the remaining 6%. A formal comparison in 392 of the above patients demonstrated the address card method to be significantly more efficient than interrogation by experienced health visitors. A retrospective comparison suggested that the efficiency of experienced health visitors was slightly better than that of highly motivated registry clerks, the proportions of letters received being 72% and 65% respectively.

Community Health Nursing

An investigation of the accuracy of the home address given by patients in an urban community in South India.

Studies were undertaken in three tuberculosis clinics in Madras, a large Indian city with a good civic organization, to assess the accuracy of address recorded routinely by registry clerks at the patient's first clinic attendance. The accuracy was poor, with 20% to 30% of the letters posted not reaching the patients. It was appreciably improved, by 10% to 20%, by supplementing the clerk's efforts with questioning by a motivated, experienced health visitor. An address card, a card on which the patient's address was recorded by the local postman or a literate neighbour, relative or friend, was returned by 90% to 94% of the patients, and the accuracy of addresses was found to be at least as good as that obtained with the health visitor. Even when all three sources of information were considered, the patient's home could not be traced in 3% of cases and was found with difficulty in 4%.

Community Health Nursing

Tinea capitis in Pondicherry (South India).

Amongst 125 cases of tinea capitis, representing 12-5% of dermatomycosis, about 9% showed kerion-like lesions and 13% had tinea corporis and/or tinea unguium. Eighty four percent cases were mycologically positive, yielding Trichophyton violaceum (84%) or T. tonsurans (16%).

Adolescent

Genetic distances among the five tribal populations of Andhra, Pradesh, South India.

In this paper, data on genetic distances among five tribal populations ae given. Among the five tribes, Koya Dora, Raj Gond and Naikpod are autochthonous populations of the Deccan plateau whereas the other two groups, Pardhan and Lambadi are migrants. Kova Doras were sampled from five distant localities. Genetic markers typed are: A1A2B0, Rho(D) blood group systems glucose-6-phosphate dehydrogenase deficiency, transferrin, haptoglobin, groupspecific component, haemoglobin, colour-vision deficiency and tastability to P. T. C. Using frequency data for the above nine genetic loci, genetic distances between the five endogamous tribes, and between the five groups of Koya Dora are calculated by adopting the statistical method of Edwards (1971). While genetic distances between Koya Dora, Raj Gond and Lambadi are minimal, the genetic distance between Pardhans and other tribal groups is maximum. Naikpods occupy an intermediate position. The closeness of Lambadi with Koya Dora and RAJ Gond can be regarded as coincidental. Interestingly, the differences in the genetic distance values between five Koya Dora groups are as great as the differences between the five endogamous tribal populations tested for the same loci. Genetic affinities of these tribal populations are discussed in relation to their ethnic origin migration and geographical isolation.

Adult

Acremonium recifei as an agent of mycetoma in India.

Acremonium recifei was identified as the causal agent in a case of white grain eumycotic mycetoma of the hand which occurred in South India. The identification was based on the structure of the granules in tissue and on the morphological characteristics of the culture obtained from the granules. This case represents the first documented instance in which A. recifei has been found outside of Latin America.

Adult